Healthcare Provider Details

I. General information

NPI: 1194139857
Provider Name (Legal Business Name): CHRISTOPHER ATWELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2014
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BANNER DESERT MEDICAL CENTER ATTN: HOSPITALISTS 1400 S DOBSON RD
MESA AZ
85202
US

IV. Provider business mailing address

BANNER DESERT MEDICAL CENTER ATTN: HOSPITALISTS 1400 S DOBSON RD
MESA AZ
85202
US

V. Phone/Fax

Practice location:
  • Phone: 480-412-6788
  • Fax: 480-412-6848
Mailing address:
  • Phone: 480-412-6788
  • Fax: 480-412-6848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number53937
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number53937
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: